Pacemaker Dislocation -
Truly Ectopic Activation
Necessitating Surgical Treatment

Abstract

Intra-abdominal migration of a generator from an epicardial pacemaker system is a rare but potentially life-threatening complication. We report on a case of a 2-year-old child in whom the generator silently migrated from the sheath of the rectus abdominis muscle in the upper abdominal wall down into the peritoneal cavity. We advise that if there is any evidence of intra-abdominal migration, the generator should be properly repositioned without delay.

Key words

Artificial pacemaker - Pediatrics - Heart-block therapy

References

• 1 Lau Y R. Lead selection. In: Gillette PC, Zeigler VL, eds Pediatric cardiac pacing. New York: Futura Publishing Co 1995: 30
• 2 Crossley G H, Brinker J A, Reynolds D, Spencer W, Johnson W B, Kurd H, Tonder L, Smijewski M. Steroid elution improves the stimulation threshold in an active-fixation atrial permanent pacing lead. A randomized, controlled study. Model 4068 Investigators.  Circulation. 1995;  92 (10) 2935-2939
• 3 Gomez C, MacDonald D II, Hernandez R, Coran A G, Crowley D, Serwer G A. Peritoneal migration of an abdominally implanted epicardial pacemaker: A cause of intestinal obstruction.  PACE. 1995;  18 2231-2232
• 4 Salim M A, DiSessa T G, Watson D C. The wandering pacemaker: intraperitoneal migration of an epicardially placed pacemaker and femoral nerve stimulation.  Pediatric Cardiol. 1999;  20 (2) 164-166
• 5 Siclari F, Uhlschmid G, Zwicky P, Turina M. Intracolonic migration of a pacemaker generator.  Thorac Cardiovasc Surgeon. 1986;  34 338-339
• 6 Van Hare G F, Witherell C, Merrick S M. Migration of an epicardial pacemaker to the pericardial space in an infant.  PACE. 1994;  17 (11) 1808-1810

Correspondence